[Dietetic factors in epidemic neuropathy on Isla de la Juventud, Cuba]

The epidemic of neuropathy that arose in Cuba in late 1991 has clinical manifestations similar to those of other neuropathies that are nutritional in origin. In an effort to identify its possible association with the diet, a case-control study was conducted at the beginning of the epidemic in Isla de la Juventud. Dietary intake was assessed through a semi-quantitative survey of consumption frequency obtained by direct personal interviews, and measurements were taken of the weight, height and skin fold thickness of 34 cases and 65 controls. As compared to controls, cases showed more pronounced weight loss prior to becoming ill, a lower body mass index (BMI), a lower percentage of body fat, and a poorer diet. According to odds ratios (OR) resulting from the separate analysis of each variable, factors associated with illness were weight loss, low BMI, low weight for height, a lower consumption of bread and rice, a less balanced diet, lack of milk intake, an intake of sugar greater than 15% of total energy consumed, consumption of alcohol, and smoking. The association was protective in the case of beans, tubercles, starchy roots, oil, and meat substitutes made from soy. Multifactorial analysis revealed higher OR values, adjusted for smoking and alcohol consumption, for intakes of less than 50% of the recommended daily allowance of protein, pyridoxine, thiamine, energy, vitamin E, niacin, folic acid, fat, riboflavin, and vitamin A. The results of this analysis show that tobacco and alcohol promote the effects of a deficient diet, but do not in and of themselves explain the association. A global analysis of these results leads to the conclusion that a diet poor in energy, calories, fats, and those micronutrients that have come under study, and that is unbalanced because of a relative excess of sugars, with its resulting effect on body weight, is strongly associated with and causally related to epidemic neuropathy.